Provider Demographics
NPI:1215139076
Name:BOSMAN, DJIMMER (PT)
Entity type:Individual
Prefix:
First Name:DJIMMER
Middle Name:
Last Name:BOSMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 E BELLEVIEW AVE
Mailing Address - Street 2:A-80
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2903
Mailing Address - Country:US
Mailing Address - Phone:303-689-2222
Mailing Address - Fax:303-773-0804
Practice Address - Street 1:8101 E BELLEVIEW AVE
Practice Address - Street 2:A-80
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2903
Practice Address - Country:US
Practice Address - Phone:303-689-2222
Practice Address - Fax:303-773-0804
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist